Posted by Ritch on February 13, 2002, at 23:21:59
In reply to Re: OCD?, posted by petalpusher54 on February 13, 2002, at 13:22:55
> > > > > Dear Dr Bob,
> > > > > I came across your site when I was trying to find out what is the difference between gaba and gabatril. Maybe it is fate and you can help me. My 20 year old son suffers from severe OCD morning, noon and night. He has been this way since the age of 15. He can not stop these raging thoughts from tormenting him. He has been on 22 different meds, from anticonvultants, antidepressants, SSRI's, to all types of anxiety, benzos etc, etc. The ONLY thing that has made him feel normal is ambien. We accidentally discovered this when I gave him a ambien 10mg once during the day and he, within 10 to 15 minutes he came back with a smile (something I hadn't seen in months), and said he felt great! He said he felt like he had drank a few glasses of wine and that his thoughts weren't bothering him any more. Well of course as you know, ambien is usually used as a sleeping pill but on him, it allows him to just feel normal, not a bit sleepy-- other problems first, ambien is addictive given this frequently, second ambien affects wear off within 3 hours. His primary doctor aware of the fact that most medicines act in the reverse with his system said he would prescribe ambien 5mg every 3 hours (30mg daily) just to give him some relief. Well we had a hard time getting the scrip filled by our pharmacy who said it was against his better judgement to fill a drug like ambien when it was not meant to be used in this way. As a matter of fact we had to go to 2 other pharmacys in order to get someone to fill it. My sons took the pill every 3 hours while awake for 4 weeks (just enough time to get him through our daughters wedding) when it began to loose its affect and eventually didn"t help at all. That was last August, and since then he has had no relief. He just sits in his room and trys to deal with the thoughts for hours and hours. He has no life. We have been to 5 different psychiatrists and they all are stumped. We have tried everything from vitamins, True Hope, to Bach flower Remedies on the alternative medicine side. We, my husband, my daughter and especially my son are mentally and physically worn out and we are looking for anything and anyone who might be able to give him some relief and some life. He as been on gabitril and some other anticonvulsants and they had made him violent (throwing things across the room). We wondered if the natural gaba offered by health stores has the same ingredience as gabitril? Would you or your colleagues be able to give us any direction?
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> > > > I don't know if this would help much, but has a diagnosis of schizophrenia or schizo-affective disorder been ruled out by the psychiatrists that you have been to? You didn't mention any trial of an antipsychotic in the meds you listed. That is interesting that he responded to a hypnotic like Ambien. Has he ever been to a neurologist and had any EEG's done to rule out epilepsy? You didn't mention any neurological exams. Hope this gets clearer for you,
> > > >
> > > > Mitch
> > >
> > > Mitch,
> > > Thank you for taking the time to help with our problem. His EEG was abnormal, demonstrating bitemporal sharp waves which, on some occasions appeared more prominent on the left than the right. During a 24 hour ambulatory EEG he had rare episodes of epileptiform activity in the left temporal as well as bitemporal at times. It was recommended at that time to try him on Tegretol building up to 300 mg. t.i.d.if ineffective the doctor suggested trying him on Depakote. This study was done at Einstein Med. Phila. 2 years ago. Unfortunately at 18 years of age My son refused to be put on these type of sedating meds. It is interesting that you asked about epilespy, any other thoughts?
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> > > Also he has been on Risperdal 4.5 mg. and Zyprexa 5-10 mg. over a period of 4 months both making him feel very shakey and restless.
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> > > The only diagnosis has been OCD.
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> >
> > Wow, left temporal epileptiform activity. That could explain the intrusive thinking. Well Tegretol is pretty much the "gold standard" for temporal lobe seizures. Since you mentioned Ambien helping, have you ever tried Klonopin? Oh, I just thought of something else that might be better that you might not have tried yet.. What about Tranxene (clorazepate), or clobazam (in Canada). They are both benzos that are particular effective for complex partial seizures (more so than Klonopin). Just some thoughts.
> >
> > good luck,
> >
> > Mitch
>
> Dear Mitch,
> Thanks for your reply. Visited our primary dr yesterday, asked him about tranxene, he spent about 20 minutes looking into several books and gave us a prescription for Clozapine, 25 mg. 2 times a day for one week then 50 mg. 2 times a day for one week, then 100 mg. 2 times a day for the next 2 weeks. He wants to see us back in a month for a blood test. Frankly, I am really frightened by the drug warning that clozapine has caused severe, even fatal, blood disorders (agranulocytosis). What's your thoughts?Hi, I have taken several conventional and a couple of the newer antipsychotics over the years for bipolar. It sounds to me that your pdoc is wondering whether his symptoms are actually schizophrenia or schizo-affective symptoms. Have you asked him directly if he is reconsidering the OCD diagnosis or is he just considering his OCD "treatment-resistant" and is pursuing antipsychotics as a potential solution?? In other words, does he think your son has a thought disorder which is a symptom of psychosis rather than OCD? This is kind of strange giving antipsychotics when his EEG shows spikes you have described. Is his pdoc a neurologist? Clozapine is the new "gold-standard" treatment for schizophrenia. What do *you* think-is it psychosis or OCD? Have you gotten a 2nd opinion? Generally, antipsychotics don't work too well for OCD.
Mitch
poster:Ritch
thread:93617
URL: http://www.dr-bob.org/babble/20020208/msgs/94083.html